SESSION CONTENT:

HISTORICAL BACKGROUND
DEFINATION:
PRINCIPLES:
CHARACTERSTICS:
PHYSIOLOGICAL EFFECTS:
ELECTRODE:
INTENSITY OF TREATMENT:
DURATION OF TREATMENT:
FREQUENCY OF TREATMENT:
INDICATIONS:
ADVANTAGE OF IFC:
CONTRAINDICATIONS:
PRECAUTIONS:
PRACTICAL APPLICATIONS:
REFERENCES:

Historical Background
 Intro. by Dr. Nemec in Vienna in the early 1950’s.
 He wanted to overcome the problems of discomfort caused by low-
frequency currents, while maintaining their claimed therapeutic
effect.
 Its intro. coincided with arrival of some powerful drugs, and on top of
that,electrotherapy was considered as a palliative form of treatment.
 It disappeared until late 1960s and 1970s when work on pain
mechanism by
 Melzak/Wall showed that pain could be decreased by stimulating
primary afferent neurons.
DEFINATION:
 The transcutaneous application of alternating medium-frequency
electrical currents, amplitude modulated at low frequency for
therapeutic purposes.
 As it is obtained as a result of interference of two different medium
frequency currents, named as interferential therapy.
medium frequency A + medium frequency B = low (therapeutic)
frequency C
PRINCIPLES:
The principle upon which IFT based is that, it is obtained as a result of
interference of two different medium frequency currents cross in the
patients tissue.
The main prob.associated with the direct application of low frequency
currents (faradic or sinusoidal current) to patient is the very high skin
impedence,while MFC around 4000 hz able to stimulate motor and sensory
nerves with a low skin impedence.
Medium frequency currents associated with a lower skin resistance
(impedance),thus more comfortable than low frequency currents. using a
medium frequency, a more tolerable penetration of current through the
skin is possible.
Z=1/2 π fc
z=impendence
f=frequency
c=capacitance
CHARACTERSTICS:
1.CURRENTS:
 Two MFC are used to produce the IFC.
 They are known as carreier waves as they don’t produce
muscle/nerve stimulation & are used to get the greater depth of
penetration and to produce interference.
 Out of two MFC,the frequency of one is fixed and frequency of other
is lies between 4000-4100 which is adjustable.
 When these currents crosses each other they will produce a 3rd
current at the point where they crosses each other & this current is
known as interferential current.
2.BEAT FREQUENCY:
 The frequency of resultant current is known as beat frequency.
 Beat frequency is equal to diff between two MFC,lies between 1-
100hz.
 Beat frequency is kept constant or varied rhythmically to prevent
accommodation.
 Constant beat frequency is also called as selective beat
frequency.selected from 0-100 hz
 Variable beat frequency also called as automatic beat frequency
 Various variable beat frequency can be used such as:
 0-5 hz-stimulates sympathetic nerves
5-10 hz-stimulates parasympathetic nerves
10-50hz-stimulates motor nerve
50-90hz-sedative and spasmolytic effect
90-100hz- analgesic effect
3.AREA OF INTERFERENCE:
 It is the area where interferential current is set up.
 The pattern of interferential area may be static/dynamic.
 There are two types of interference occurs.static/dynamic
STATIC INTERFERENCE:
here the area in which IFC is set –up remains stationary.this area of static
interference gives an appearance of clover leaf.as a result of vector addition
of two currents and it from each other.lies 45 degree angle to the
perpendicular line from each electrode.
CLOVER LEAF CH-1

45
CH-2 CH-2

INTENSITY SIMILAR
CH1

DYNAMIC INTERFERENCE:it is possible to move the area in which

interference current is developed in a to and fro manner through 45
degree.it is obtained by varying the current intensity in suitablr
manner.current is varied from 50-100%.the resultant is shifted towards
more intensity channel.this dynamic area of interference is also called as
vector sweep/vector scan/rotating vector etc.
 CLOVER LEAF CH-1

CH-2 CH-2

INTENSITY CH-1 > CH-2

CH1

PHYSIOLOGICAL EFFECTS:
The physiological effects vary with factors like magnitude of
current,rhythem/constant mode,frequency,and electrode positioning.
The effects of IFT are
1.relief of pain
2.motor stimulation
3.absorption of exudates/reduction of ordema
4.relief of muscle spasm.
RELIEF OF PAIN:
 Painrelief may occure as a result of removal of irritants/pain
substances.
 IFC can stimulate autonomic nerves,which results in vasodilation &
improved circulation,which remove the waste products /pain
substances from the site of application.
 Pain relief may due to activation of pain gate mechanism.
 Pain relief may also occure due to placebo effect.
MOTOR STIMULATION:
 Normal innervated muscle will be made to contract of inteferential
frequencies between 1-100hz.
 At low frequency a twitch is produced ,between 5-20 hz a partial
tetany,from 30-100 hz titanic contraction.
 A comlete range of all muscle contraction can be seen when a
rhythmical frequency of 1-100hz is used.
ABSORPTION OF EXUDATES:
This is accelerated by frequency of 1-10hz rhythmic.As a rhythmic pumping
action is produced by muscle contraction& autonomic effect results
vasodilatation leads to increase circulation,these two factors helps in
absorption of exudate resulting reduction of oedema.
RELIEF OF MUSCLE SPASM:
IFT 50-90 hz for muscle spasm.
ELECTRODE:
Electrodes are conductors ,which are used to allow the easy passage of
therapeutic currents to the body.
Types of Electrodes:
1) Plate Electrodes:
 plates made of conducting rubber which are comfortable and long
lasting
 larger plates give more comfortable treatment and deeper effect
 smaller plates are used for a localized effect, but this effect is more
superficial
 plates are attached to the patient by means of straps or bandages
 be sure to have good contact of the plate with the patient for more
pleasant treatment and greater tolerance of current.
 Covering: -the electrodes must be fully covered with absorbent
material
 coverings should be soaked in water or a solution of bicarbonate of
soda to conduction and allow a more comfortable contact with skin
 the coverings must be kept clean and washed thoroughly and dried
after use.
2) Vacuum Electrodes
 the IFC unit is plugged into a vacuum unit a rubber suction cup
connected to a machine capable of producing a vacuum
 they’re really plate electrodes kept in position by a vacuum instead of
bandaging.
 around the neck of the cup is a rubber collar covering a small hole
 by lifting the collar, air is let into the cup, thus allowing the electrode
to be moved while the vacuum is in operation.
 do not try and tug off the electrode from the patient without releasing
the vacuum discomfort and bruising may result!
 place wet sponges in the cups and moisten the edges of the cups for
better adherence.
 the suction should not be constant uncomfortable and causes
bruising
  it may be pulsed and adjusted to increase and decrease at a desired
speed.
 vacuum electrodes are excellent for treating flat smooth areas e.g.
back or a plump knee.
 not ideal for hairy areas can’t get an airtight seal.
3)Labile electrode:
 It is a special type of plate electrode,which is insulated on one side & is
covered with sponge to provide contact.
 Two electrodes are used for treatment porpose,the operator hold them
in position while treating.
 Usually one side of electrode is insulated or operator put on the gloves
so that current doesn’t pass through operators hand.
 It is useful in treatment of muscular conditions awkward areas.

3) Combined Electrodes:
 all four contacts are embedded in some insulating material and can be
applied as one pad.
 there are different sizes (small, medium and large) for different
surfaces to be treated.
 limited by the low intensity of current that can be tolerated ,general
effect is small.
 if possible, use larger separate plate electrodes!!
INTENSITY OF TREATMENT
 Use an intensity of current which produces a strong but comfortable
prickling without a muscular contraction
steps to follow:
1) current until the patient feels a definite prickling, and leave for one
minute for it to decrease.
2) current again until the patient reports a slight muscular contraction, then
decrease until contraction stops.
May teach the patient to increase intensity periodically in order to obtain
longer lasting pain relief.
DURATION OF TREATMENT:
 IFC usually applied for 10-15 minutes
 Treatment at a normal intensity should not be given to one area for
longer than 20minutes.
 If more than one area is to be treated , total time should not exceed
30 min.
 Too long a Rx makes pt. unacceptably tired later in the day!
FREQUENCY OF TREATMENT:
 in most cases, treatment every other day (i.e. 3x/wk.) is ideal /once
daily.
 treatment less than twice/week is usually a waste of time
 a course of 12 -20treatments is given.
INDICATIONS:
PAIN RELIEF PHANTOM PAIN
MUSCLE SPASM BURGER’S DISEASE
IMPROVE VENOUS LYMPHATIC DRAINAGE MYELGIA
OA MYOSITIS
AS OEDEMA
LBP BURSITIS
SCIATICA TENDONITIS
SPONDYLOSIS FRACTURE
FZ ISCHEMIC PAIN
STRESS INONTINENCE
NOCTURNAL ENURESIS

ADVANTAGE OF IFC:
 donot produce any sensory motor irritation.
 metal is not contraindicated for IFT.
 post-op cases may be treated
 greater depth of penetration with less skin resistance
 current can be applied to a specific area.
CONTRAINDICATIONS:
1)ARTERIAL DISEASE
 the stimulatory effect of the current could produce emboli
2) DEEP VEIN THROMBOSIS
 in the acute phase, it is possible to dislodge the thrombi or increase the
inflammation of the phlebitis.
3) INFECTIVE CONDITIONS
 could spread the infection or exacerbate due to the stimulatory effects
of the current
4) PREGNANT UTERUS
 not safe for fetus
 may however use for S.I. joint strain during pregnancy if IFC placed
superficially over S.I. ligaments.
5) DANGER OF HAEMORRHAGE
 stimulating effect can cause an in bleeding
6) MALIGNANT TUMORS
 direct stimulation of tumor is CI, but reffered pain from cancer or
metastasis can be treated.
7) ARTIFICIAL PACEMAKERS
 a demand unit must sense the electrical activity of the heart, thus avoid
an electric device that may interfere with it.
8) LARGE OPEN WOUNDS
 these will cause concentration of the current and distortion of the IF
field.
9) DERMATOLOGICAL CONDITIONS
 IFC may exacerbate any dermatological condition in the area being
treated.

POSSIBLE DANGERS:/PRECAUTION:
 Burns – high intensity currents can cause sufficient heating to cause
a burn. The patient should be given warnings which include the
word BURN
 Mains current shock – faulty equipment
 Electric shock – abrupt application of high intensity current – turn
current up/ down slowly.
 Care should be taken to maintain the suction of vaccum as it may
cause discomfort to patient.
 If there is abnormal skin sensation electrode should be placed in a
side other than that area.
 Pt.who have epilepsy,advanced cardiovascular erythema should be
needed with the consultation of proper medical practitinor.

PRACTICAL APPLICATION:
 Machine check - plugs, cable, electrodes etc.
 Test machine
 Position patient comfortably
 Explain nature of the treatment, what they will feel and the
benefits
 Prepare and wash the skin
 Inspect skin for any lesions - cover with petroleum jelly
Preparation of the skin: Skin has a high electrical resistance as the
outer surface is dry and contains few conducting ions

 Skin is normally washed to remove excess oils and to moisten it.

 Any lesions can cause a concentration of current which will
result in pain.
 Small lesions can be insulated with petroleum jelly.
PLACEMENT OF ELECTRODE:
 Traditional method of applying IFC is 4 electrodes supplied by two
channels.
 Bipolar (premodulated) mode can use only two electrodes because the
two
  medium frequency currents are added inside the machine to produce
the low freq. output!
 DIS ADV. OF BIPOLAR MODE: there is more sensory stimulation,
since the low freq.current is already produced by the machine, and has
to go through the skin LEADS TO unpleasant.

 Position electrodes - must be moistened

 The four electrodes are arranged in two circuits - apply to the
patient at right angles to each other
 If using two electrodes only, use the (variable) circuit.
 Electrodes are attached by suction or bandages/ elastic straps.

Select treatment parameters:

• Power on
• Time
• Base & peak frequency
 • Swing pattern/SPECTRUM
• Output /INTENSITY.
THERAPEUTIC USES:
0-5 hz-stimulates sympathetic nerves
5-10 hz-stimulates parasympathetic nerves
10-50hz-stimulates motor nerve
50-90hz-sedative and spasmolytic effect
90-100hz- analgesic effect

A.Relief of pain – pain gate theory

 80-100Hz (higher IFT frequencies)
 Stimulates Aβ fibres
 To inhibit impulse transmission in A∂ and C fibres
 Used for both acute and chronic pain
 Temporary pain relief
Therapeutic Uses
B.Relief of pain – Ascending pain suppression, 2-30Hz (lower
frequencies)
 Stimulates A∂ fibres:
 To inhibit C fibre transmission
 Via the release of encephalins and endorphins
 More longer lasting pain relief
 Only effective on chronic pain
C.Reduction of oedema 0-100 Hz
 Stimulates autonomic nerves to produce vasodilatation
 Increases circulation
D.Motor stimulation
 0-25 Hz - twitch
 25-100 Hz - muscle contraction
 Can be used to treat incontinence or muscle weakness secondary
to trauma/surgery (in conjunction with active exercise).
SUGGESTED TREATMENT REGIMES:
Pain
80-100 Hz 15 minutes
4 Hz constant 15 minutes
Circulation
0-100Hz 20-30 minutes
 Muscle stimulation
10-50 Hz 15 minutes
50Hz constant with surge
Incontinence
Stress incontinence - 10-50Hz, surge
15 minutes.
Urge incontinence - 5-10Hz 10 minutes

Termination of treatment:
 Remove electrodes
 Inspect the skin
References:
 Low J. and Reed A. (1992) Electrotherapy Explained:
Principles and Practice. Oxford
 Watson T. (2000) The role of electrotherapy in contemporary
physiotherapy practice. Manual Therapy Aug:5(3);132-41
FEATURES:
1.4KHZ PRIMARILY FOR ANALGESIC EFFECT AND
STIMULATION OF THE CIRCULATION.
2KHZ PRIMARILY FOR MUSCLE STRENGTHENING.
2.TWO ELECTRODE PLACEMENT:BIPOLAR METHOD.:
 HERE THE AMF(AMPLITUDE MODULATED MEDIUM
FREQUENCY ALTERNATING CURRENT)IS GENERATED
INSIDE EQUIPMENT &SUPPLIED TO PATIENT
THROUGH TWO ELECTRODE.
 THIS METHOD MAKES IT VERY EASY TO LOCALISE
THE AREA OF STIMULATION BKZ THE AMF IS
PRESENT IN THE ENTIRE REGION BETWEEN TWO
ELECTRODE.
 IT IS PERTICULARLY SUITABLE FOR TREATMENT OF
TRIGGER POINT.
 USE ONLY VARIABLE CHANNEL.HERE CHANEL1.
3.PROGRAMME NO.25-29 OF IFT ARE SPECIAL TYPE OF 2EL
WAVE FORM,HERE 2EL WAVE FORM AVAILABLE IN BOTH
CHANEL.THEY CAN BE PLACED IN TWO DIFF PLACES OF
BODY,BASE AND SPECTRUM ARE NOT FUNCTIONAL
DURING THIS MODE.FIXED STIMULATING FREQUENCY IS
MENTIONED BY THE SIDE.
4.BASE AND SPECTRUM VARIATION:
 THE ADJUSTABLE SPECTRUM AVOIDS THE
ADAPTATION OF TISSUES TO A PERTICULARLY
FREQUENCY .
 RECTANULAR SPECTRUM IS THE MILD ONE,FOR
CHRONIC DISORDER THIS SPECTRUM IS PREFRABLE.
 THE TRAPEZOIDAL SPECTRUM IS MILDER THAN THE
RECTANGULAR SPECTRUM.FOR SUBACUTE
DISORDER THIS IS PREFRABLE.
 THE TRINGLAR/LINEAR SPECTRUM IS USED FOR
PAINFUL AND ACUTE DISORDER.
5.QUADRIPOLAR METHOD IS USED FOR TREATMENT OF
DEEPER TISSUE.MAX AMF IS OBTAINED AT THE
INTERSECTION OF TWO CHANNEL.
6,FOUR POLE METHOD USING AUTOMATIC VECTOR
SCAN(EG.4EL45/90):IN THIS TECH. THE INTENSITY OF THE
ONE OF THE ALTERNATING CURRENT IS VARIED,AS
ARESULT OF WHICH POINT OF SUPERIMPOSITION
ROTATES WITH IN THE AREA OF INTERSECTION
ENLARGING THE AREA OF TRAETMENT.
 THIS TREATMENT IS SUITABLE WHEN THE POINT TO
BE TREATED CANT BE LOCALISED,
6.PROGRAMME NO.1-12=4KHZ.....13-24=2KHZ
 1,5,913,17,21, ARE BIPOLAR(2EL)BOTH CHANNEL CAN
BE USED.
 1234 TRINGUAR
 5678 RECTANGULAR
 9,10,11,12, TRAPEZOID.......SO ON REPITITION UP TO 24.
 25,26,27,=4KHZ.......28,29=2KHZ.